Review of Randomized Controlled Trials of Massage in Preterm Infants
Abstract
:1. Introduction
2. Results
2.1. Weight Gain
2.2. Caloric Intake and Expenditure
2.3. Vagal Tone
2.4. Gastric Motility
2.5. Immunological Effects
2.6. Bone Metabolism
2.7. Behavior, Sleep and Neurodevelopment
2.8. Length of Hospital Stay
2.9. Serum Markers
2.10. Bilirubin levels, markers of brain maturation, pain
3. Discussion
4. Conclusions
Conflicts of Interest
References
- Hamilton, B.E.; Martin, J.A.; Osterman, M.J.; Curtin, S.C.; Matthews, T.J. Births: Final data for 2014. Natl. Vital Stat. Rep. 2015, 64, 1–64. [Google Scholar] [PubMed]
- Saeadi, R.; Ghorbani, Z.; Shapouri Moghaddam, A. The effect of massage with medium-chain triglyceride oil on weight gain in premature neonates. Acta Med. Iran. 2015, 53, 134–138. [Google Scholar] [PubMed]
- Basiri-Moghadam, M.; Basiri-Moghadam, K.; Kianmehr, M.; Jani, S. The effect of massage on neonatal jaundice in stable preterm newborn infants: A randomized controlled trial. J. Pak. Med. Assoc. 2015, 65, 602–606. [Google Scholar] [PubMed]
- Yates, C.C.; Mitchell, A.J.; Booth, M.Y.; Williams, D.K.; Lowe, L.M.; Whit Hall, R. The effects of massage therapy to induce sleep in infants born preterm. Pediatr. Phys. Ther. 2014, 26, 405–410. [Google Scholar] [CrossRef] [PubMed]
- Diego, M.A.; Field, T.; Hernandez-Reif, M. Preterm infant weight gain is increased by massage therapy and exercise via different underlying mechanisms. Early Hum. Dev. 2014, 90, 137–140. [Google Scholar] [CrossRef] [PubMed]
- Smith, S.L.; Lux, R.; Haley, S.; Slater, H.; Beachy, J.; Moyer-Mileur, L.J. The effect of massage on heart rate variability in preterm infants. J. Perinatol. 2013, 33, 59–64. [Google Scholar] [CrossRef] [PubMed]
- Smith, S.L.; Haley, S.; Slater, H.; Moyer-Mileur, L.J. Heart rate variability during caregiving and sleep after massage therapy in preterm infants. Early Hum. Dev. 2013, 89, 525–529. [Google Scholar] [CrossRef] [PubMed]
- Moyer-Mileur, L.J.; Haley, S.; Slater, H.; Beachy, J.; Smith, S.L. Massage improves growth quality by decreasing body fat deposition in male preterm infants. J. Pediatr. 2013, 162, 490–495. [Google Scholar] [CrossRef] [PubMed]
- Kumar, J.; Upadhyay, A.; Dwivedi, A.K.; Gothwal, S.; Jaiswal, V.; Aggarwal, S. Effect of oil massage on growth in preterm neonates less than 1800 g: A randomized control trial. Indian J. Pediatr. 2013, 80, 465–469. [Google Scholar] [CrossRef] [PubMed]
- Fallah, R.; Akhavan Karbasi, S.; Golestan, M.; Fromandi, M. Sunflower oil versus no oil moderate pressure massage leads to greater increases in weight in preterm neonates who are low birth weight. Early Hum. Dev. 2013, 89, 769–772. [Google Scholar] [CrossRef] [PubMed]
- Haley, S.; Beachy, J.; Ivaska, K.K.; Slater, H.; Smith, S.; Moyer-Mileur, L.J. Tactile/kinesthetic stimulation (TKS) increases tibial speed of sound and urinary osteocalcin (U-MidOC and unOC) in premature infants (29–32 weeks PMA). Bone 2012, 51, 661–666. [Google Scholar] [CrossRef] [PubMed]
- Ang, J.Y.; Lua, J.L.; Mathur, A.; Thomas, R.; Asmar, B.I.; Savasan, S.; Buck, S.; Long, M.; Shankaran, S. A randomized placebo-controlled trial of massage therapy on the immune system of preterm infants. Pediatrics 2012, 130, e1549–e1558. [Google Scholar] [CrossRef] [PubMed]
- Guzzetta, A.; D’Acunto, M.G.; Carotenuto, M.; Berardi, N.; Bancale, A.; Biagioni, E.; Boldrini, A.; Ghirri, P.; Maffei, L.; Cioni, G. The effects of preterm infant massage on brain electrical activity. Dev. Med. Child Neurol. 2011, 53 (Suppl. 4), 46–51. [Google Scholar] [CrossRef] [PubMed]
- Procianoy, R.S.; Mendes, E.W.; Silveira, R.C. Massage therapy improves neurodevelopment outcome at two years corrected age for very low birth weight infants. Early Hum. Dev. 2010, 86, 7–11. [Google Scholar] [CrossRef] [PubMed]
- Ho, Y.B.; Lee, R.S.; Chow, C.B.; Pang, M.Y. Impact of massage therapy on motor outcomes in very low-birthweight infants: Randomized controlled pilot study. Pediatr. Int. 2010, 52, 378–385. [Google Scholar] [CrossRef] [PubMed]
- Massaro, A.N.; Hammad, T.A.; Jazzo, B.; Aly, H. Massage with kinesthetic stimulation improves weight gain in preterm infants. J. Perinatol. 2009, 29, 352–357. [Google Scholar] [CrossRef] [PubMed]
- Gonzalez, A.P.; Vasquez-Mendoza, G.; Garcia-Vela, A.; Guzman-Ramirez, A.; Salazar-Torres, M.; Romero-Gutierrez, G. Weight gain in preterm infants following parent-administered vimala massage: A randomized controlled trial. Am. J. Perinatol. 2009, 26, 247–252. [Google Scholar] [CrossRef] [PubMed]
- Mendes, E.W.; Procianoy, R.S. Massage therapy reduces hospital stay and occurrence of late-onset sepsis in very preterm neonates. J. Perinatol. 2008, 28, 815–820. [Google Scholar] [CrossRef] [PubMed]
- Field, T.; Diego, M.; Hernandez-Reif, M.; Dieter, J.N.; Kumar, A.M.; Schanberg, S.; Kuhn, C. Insulin and insulin-like growth factor-1 increased in preterm neonates following massage therapy. J. Dev. Behav. Pediatr. 2008, 29, 463–466. [Google Scholar] [CrossRef] [PubMed]
- Diego, M.A.; Field, T.; Hernandez-Reif, M. Temperature increases in preterm infants during massage therapy. Infant Behav. Dev. 2008, 31, 149–152. [Google Scholar] [CrossRef] [PubMed]
- Chen, L.L.; Su, Y.C.; Su, C.H.; Lin, H.C.; Kuo, H.W. Acupressure and meridian massage: Combined effects on increasing body weight in premature infants. J. Clin. Nurs. 2008, 17, 1174–1181. [Google Scholar] [CrossRef] [PubMed]
- Lahat, S.; Mimouni, F.B.; Ashbel, G.; Dollberg, S. Energy expenditure in growing preterm infants receiving massage therapy. J. Am. Coll. Nutr. 2007, 26, 356–359. [Google Scholar] [CrossRef] [PubMed]
- Hernandez-Reif, M.; Diego, M.; Field, T. Preterm infants show reduced stress behaviors and activity after 5 days of massage therapy. Infant Behav. Dev. 2007, 30, 557–561. [Google Scholar] [CrossRef] [PubMed]
- Diego, M.A.; Field, T.; Hernandez-Reif, M.; Deeds, O.; Ascencio, A.; Begert, G. Preterm infant massage elicits consistent increases in vagal activity and gastric motility that are associated with greater weight gain. Acta Paediatr. 2007, 96, 1588–1591. [Google Scholar] [CrossRef] [PubMed]
- Jain, S.; Kumar, P.; McMillan, D.D. Prior leg massage decreases pain responses to heel stick in preterm babies. J. Paediatr. Child Health 2006, 42, 505–508. [Google Scholar] [CrossRef] [PubMed]
- Field, T.; Diego, M.A.; Hernandez-Reif, M.; Deeds, O.; Figuereido, B. Moderate versus light pressure massage therapy leads to greater weight gain in preterm infants. Infant Behav. Dev. 2006, 29, 574–578. [Google Scholar] [CrossRef] [PubMed]
- Solanki, K.; Matnani, M.; Kale, M.; Joshi, K.; Bavdekar, A.; Bhave, S.; Pandit, A. Transcutaneous absorption of topically massaged oil in neonates. Indian Pediatr. 2005, 42, 998–1005. [Google Scholar] [PubMed]
- Sankaranarayanan, K.; Mondkar, J.A.; Chauhan, M.M.; Mascarenhas, B.M.; Mainkar, A.R.; Salvi, R.Y. Oil massage in neonates: An open randomized controlled study of coconut versus mineral oil. Indian Pediatr. 2005, 42, 877–884. [Google Scholar] [PubMed]
- Lee, H.K. The effect of infant massage on weight gain, physiological and behavioral responses in premature infants. Taehan Kanho Hakhoe Chi 2005, 35, 1451–1460. [Google Scholar] [CrossRef] [PubMed]
- Diego, M.A.; Field, T.; Hernandez-Reif, M. Vagal activity, gastric motility, and weight gain in massaged preterm neonates. J. Pediatr. 2005, 147, 50–55. [Google Scholar] [CrossRef] [PubMed]
- Arora, J.; Kumar, A.; Ramji, S. Effect of oil massage on growth and neurobehavior in very low birth weight preterm neonates. Indian Pediatr. 2005, 42, 1092–1100. [Google Scholar] [PubMed]
- Aly, H.; Moustafa, M.F.; Hassanein, S.M.; Massaro, A.N.; Amer, H.A.; Patel, K. Physical activity combined with massage improves bone mineralization in premature infants: A randomized trial. J. Perinatol. 2004, 24, 305–309. [Google Scholar] [CrossRef] [PubMed]
- Ferber, S.G.; Kuint, J.; Weller, A.; Feldman, R.; Dollberg, S.; Arbel, E.; Kohelet, D. Massage therapy by mothers and trained professionals enhances weight gain in preterm infants. Early Hum. Dev. 2002, 67, 37–45. [Google Scholar] [CrossRef]
- Wheeden, A.; Scafidi, F.A.; Field, T.; Ironson, G.; Valdeon, C.; Bandstra, E. Massage effects on cocaine-exposed preterm neonates. J. Dev. Behav. Pediatr. 1993, 14, 318–322. [Google Scholar] [CrossRef] [PubMed]
- Scafidi, F.A.; Field, T.; Schanberg, S.M. Factors that predict which preterm infants benefit most from massage therapy. J. Dev. Behav. Pediatr. 1993, 14, 176–180. [Google Scholar] [CrossRef] [PubMed]
- Field, T.M.; Schanberg, S.M.; Scafidi, F.; Bauer, C.R.; Vega-Lahr, N.; Garcia, R.; Nystrom, J.; Kuhn, C.M. Tactile/kinesthetic stimulation effects on preterm neonates. Pediatrics 1986, 77, 654–658. [Google Scholar] [PubMed]
- Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability: Standards of measurement, physiological interpretation and clinical use. Circulation 1996, 93, 1043–1065. [Google Scholar]
- American Academy of Pediatrics, Committee on Nutrition. Nutritional needs of low-birth-weight infants. Pediatrics 1985, 75, 976–986. [Google Scholar]
- Manuck, T.A.; Rice, M.M.; Bailit, J.L.; Grobman, W.A.; Reddy, U.M.; Wapner, R.J.; Thorp, J.M.; Caritis, S.N.; Prasad, M.; Tita, A.T.; et al. Preterm neonatal morbidity and mortality by gestational age: A contemporary cohort. Am. J. Obstet. Gynecol. 2016, 215, 103.e1–103.e14. [Google Scholar] [CrossRef] [PubMed]
- Stoll, B.J.; Hansen, N.I.; Bell, E.F.; Walsh, M.C.; Carlo, W.A.; Shankaran, S.; Laptook, A.R.; Sanchez, P.J.; Van Meurs, K.P.; Wyckoff, M.; et al. Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993–2012. JAMA 2015, 314, 1039–1051. [Google Scholar] [CrossRef] [PubMed]
- Wang, L.; He, J.L.; Zhang, X.H. The efficacy of massage on preterm infants: A meta-analysis. Am. J. Perinatol. 2013, 30, 731–738. [Google Scholar] [PubMed]
- Vickers, A.; Ohlsson, A.; Lacy, J.B.; Horsley, A. Massage for promoting growth and development of preterm and/or low birth-weight infants. Cochrane Database Syst. Rev. 2004, 2014, CD000390. [Google Scholar]
- Field, T.; Diego, M.; Hernandez-Reif, M. Preterm infant massage therapy research: A review. Infant Behav. Dev. 2010, 33, 115–124. [Google Scholar] [CrossRef] [PubMed]
- Field, T.; Diego, M.; Hernandez-Reif, M. Potential underlying mechanisms for greater weight gain in massaged preterm infants. Infant Behav. Dev. 2011, 34, 383–389. [Google Scholar] [CrossRef] [PubMed]
Year | First Author | Number of Infants (Cases, Controls) | Gestational Age (Age at the Time of Study) | Massage Type | Intervention | Outcomes Measured | Results |
---|---|---|---|---|---|---|---|
2015 | Basiri-Moghadam [3] | 40 (20 massage, 20 controls) | 34–36 weeks (<1 week) | N/A | 20 min of massage twice daily for 4 days | Number of defecations Transcutaneous bilirubin level | Massage group had higher number of defecations (p = 0.002) and lower levels of transcutaneous bilirubin (p = 0.003) |
2015 | Saeadi [2] | 121 (40 oil massage, 40 massage, 41 controls) | <37 weeks (<28 days) | N/A | 5 min of massage 4 times a day for 7 days | Weight gain | The MCT oil-massage group gained more weight than massage (p = 0.002) and control groups (p = 0.000) |
2014 | Yates [4] | 23 (cross-over study) | 28–37 weeks (34–48 PMA) | TKS (modified, no kinesthetic component) | 13 infants received a massage on day 1 and no massage on day 2 (10 infants received a massage on day 2) | Sleep efficiency Number of infants asleep at the end of massage | No significant difference in sleep efficiency (p = 0.13) |
2014 | Diego [5] | 30 (15 tactile, 15 kinesthetic stimulation) | 28–32 weeks; (15–60 days) | TKS (tactile or kinesthetic stimulation) | 15 infants received tactile and 15 received kinesthetic stimulation 10 min a day for 5 days (no control group without massage) | Weight gain Calorie intake Vagal activity | No difference in weight gain. Increased calorie intake in kinesthetic group (p < 0.05). Increased vagal tone in tactile group (p = 0.01), decreased vagal tone in kinesthetic group. |
2013 | Fallah [10] | 54 (17 oil massage, 17 massage alone) LBW infants | 33–37 weeks (<10 days) | Moderate pressure | 17 received moderate pressure massage alone, 17 received massage with sunflower oil 3 times a day for 14 days (no control group without massage) | Weight gain at 14 days, 1 month, 2 months | The oil massage group had a higher mean weight at ages 1 month (p = 0.04) and 2 months (p = 0.005) than the massage alone group. |
2013 | Smith [6] | 21 (10 massage, 11 controls) | 28–33 weeks (mean 31 weeks PMA) | Moderate pressure strokes with kinesthetic movement of extremities | 20 min of massage twice daily for 4 weeks | Heart rate variability (HRV) | Significant group × time × sex interaction effect (p < 0.05) with male infants who received massage demonstrating higher HRV indicating increased vagal tone. |
2013 | Smith [7] | 37 (17 massage, 20 control) | 29–32 weeks | Soft-tissue compression strokes with following range of motion to arms and legs | 20 min massage twice daily for 4 weeks | HRV | HRV improved in massage group but not in controls (p < 0.05). Male infants who received massage had a greater improvement in HRV than females (p < 0.05). |
2013 | Moyer-Mileur [8] | 44 (22 massage, 22 controls) | 29–32 weeks (32–33 weeks PMA) | Soft-tissue strokes with following range of motion to arms and legs | Twice-daily massage 6 days a week for 4 weeks | Energy and protein intake, body circumference, weight, length, ponderal index (PI), skinfold thickness (triceps, mid-thigh, subscapular), and IGF-1, leptin and adiponectin levels | Male infants in the massage group had smaller PI and skinfold thickness than control males (p < 0.05). Females in the massage group had larger subscapular skin fold increase than control females (p < 0.05). Adiponectin increased in control males (p < 0.01) and correlated to PI (r = 0.39, p < 0.01). |
2013 | Kumar [9] | 48 (25 oil massage, 23 controls) | <35 weeks (<48 h) | 20 strokes in: shoulders starting from neck with baby prone, upper back to the waist. Then limbs in supine position | 10 min 4 times a day for 28 days | Weight, length, head circumference, serum triglyceride levels | At 7 days the massage group had less weight loss compared to controls (p = 0.003). At 28 days massage group had greater weight compared to controls (p < 0.05). No significant difference in serum triglycerides and other measured parameters. |
2012 | Haley [11] | 40 (20 massage, 20 controls) | 29–32 weeks, (mean 32 weeks PMA) | TKS | 20 min twice daily, 6 days a week for 15 days | Tibial speed of sound (tSOS), urine markers of bone metabolism (pyridinium crosslinks and urinary osteocalcins (OC) U-MidOC and unOC) | Massage group had less decrease in tSOS than controls (p < 0.05). Urinary pyridinium crosslinks decreased in both massage and controls (p < 0.005). Massage group had greater increases in urinary osteocalcin (U-MidOC, p < 0.001 and unOC, p < 0.05) suggesting improved mineralization. |
2012 | Ang [12] | 120 (58 massage, 62 controls) | Mean 30 weeks, range 25–33 (mean 32 weeks PMA, range 28–33) | TKS | 5 days a week until hospital discharge for a maximum of 4 weeks | Immunologic parameters (absolute natural killer (NK) cells, T and B cells, T cell subsets, NK cytotoxicity), weight, number of infections, length of hospital stay | NK cytotoxicity was higher in the massage group, particularly in those who received ≥ 5 consecutive days of massage (p = 0.04). Infants in the massage group weighed more (p = 0.05) and had greater daily weight gain (p = 0.01) compared to controls. Other parameters, did not differ between the groups. |
2011 | Guzzetta [13] | 20 (10 massage, 10 controls) | 30–33 weeks (10 days) | TKS | 10 min of massage 3 times a day for 12 days during a 2-week period | Changes in EEG spectral activity (before and after study period) | Significant difference in EEG spectral power. |
2010 | Procianoy [14] | 73 (35 massage, 38 controls) | <32 weeks (48 h of life) | TKS (modified) | Massage and skin to skin care 15 min 4 times a day during hospital stay (skin to skin only) | Neurodevelopment (PDI, MDI) and growth at 2 years of corrected age | Massage group had higher MDI scores (p = 0.035), PDI scores and growth did not differ significantly. |
2010 | Ho [15] | 24 (12 massage, 12 controls) VLBW infants | <34 weeks (34 weeks PMA) | TKS (modified) | 15 min of massage daily, 5 days/week for 4 weeks (light still touch) | Test of Infant Motor Performance (TIMP) score gain, weight gain, post-conceptional age at discharge | No significant difference in TIMP score gain and weight gain when all subjects were analyzed. Those who had below-average pre-massage TIMP score and received massage had higher TIMP score gain (p = 0.043) and earlier discharge (p = 0.045) than controls. |
2009 | Massaro [16] | 60 (20 massage with kinesthetic stimulation, 20 massage, 20 controls) | <32 weeks, mean 29 weeks for massage groups, 27 weeks for controls (30 weeks PMA) | TKS | 15 min of massage ± kinesthetic stimulation (KS) twice daily from study enrollment until discharge | Weight gain Length of stay (LOS) | Average daily weight gain and LOS did not differ between the groups except for infants with BW > 1000 g, in whom average daily weight gain was higher in massage + KS group compared to control. |
2009 | Gonzalez [17] | 60 (30 massage, 30 controls) | <35 weeks, mean 31 weeks (30–35 weeks PMA, mean 33) | Vimala massage | 15–20 min twice daily massage for 10 days | Weight, head circumference, caloric intake, nutritional method, hospital stay | Massage group had higher weight gain (p < 0.001) and shorter hospital stay (p = 0.03) than controls. |
2008 | Field [19] | 42 (N/A) | Mean 29–30 weeks (mean 34.8 weeks PMA) | TKS | 15 min per day for 5 days | Weight gain, caloric consumption, vagal activity (high frequency component of HRV), serum insulin and IGF-1 | Vagal activity increased during massage (p < 0.001). Massage group had greater increase in weight gain (p = 0.02), insulin (p = 0.001) and IGF-1 (p = 0.05). No difference in caloric consumption was noted between groups. |
2008 | Mendes [18] | 104 (52 massage, 52 controls) VLBW infants | <32 weeks, mean 29 weeks (48 h) | TKS (modified) | 15 min 4 times a day until discharge | Length of hospital stay (primary). Other outcomes: weight, length, head circumference, growth rate, ponderal index, age of partial and total enteral feeding, age of partial and total oral feeding, incidence of late onset sepsis, necrotizing enterocolitis (NEC), bronchopulmonary dysplasia (BPD) | Massage group had a higher probability of earlier hospital discharge (p = 0.023). Incidence of late-onset sepsis was lower in the massage group (p = 0.005). |
2008 | Chen [21] | 40 (20 massage, 20 controls) | <34 weeks (>7 days) | Acupressure and meridian massage | 15 min 3 times a day for 10 days | Weight gain | During 14-day study period the massage group gained more weight (p = 0.038) There was no significant difference in weight gain in the first week (p = 0.384). In the second week, the massage group had had higher weight gain than controls (p = 0.035). |
2008 | Diego [20] | 72 (abstract) or 48 (methods)(N/A) | Mean 29 weeks (N/A) | TKS | 15 min of massage once | Temperature (15 min before, during massage and 15 min after) | Massage group had a greater increase in temperature |
2007 | Lahat [22] | 10 (cross over) | Mean 32 weeks (29–34 weeks PMA, mean 3 weeks) | TKS (modified) | 15 min 3 times a day for 5 days (5 infants received a massage for 5 days and no massage for 5 days, opposite sequence for 5 infants) | Energy expenditure by indirect calorimetry | Energy expenditure was lower in infants after the 5 days massage therapy than after the period with no massage (p = 0.05). |
2007 | Diego [24] | 70 (36 massage, 34 controls) | Mean 29 weeks (mean 30 days) | TKS | 15 min 3 times a day for 5 days | Vagal activity (HRV). Gastric motility (by EGG) measurements performed on days 1 and 5 of study 15 min before, during and 15 min after massage | Group-by-time analysis revealed significant increase in vagal activity that peaked during massage (p < 0.001); a significant increase in gastric motility that peaked 15 min after massage (p < 0.01) in the massage group. No changes in basal vagal activity or gastric motility were noted. |
2007 | Hernandez-Reif [23] | 32 (16 massage, 16 controls) | 28–32 weeks (15–60 days) | TKS | 15 min 3 times a day for 5 days | Stress behavior (crying, grimacing, yawning, jerky arm or leg movement, sneezing, startles, finger flaring). Activity (movement of the limbs, torso or gross body movement of any kind) | Group-by-time analysis showed reduction in duration of stress behaviors in massage group (p < 0.05) and reduction in overall movement for the massage group (p < 0.05). No change in controls in these parameters were observed. |
2006 | Field [26] | 68 (N/A) | 28–32 weeks, mean 30 weeks (15–60 days, mean 23) | TKS | 15 min 3 times a day for 5 days of moderate vs. light pressure massage (no control group without massage) | Behavior state, stress behaviors, heart rate, weight gain | Moderate pressure massage group had a higher increase in weight gain (p < 0.02), less decrease in deep sleep (p < 0.05), less increase in active sleep (p < 0.02), less increase in fussing (p < 0.01), less increase in crying (p < 0.02), less increase in gross movement (p < 0.05), less increase in stress behavior (p < 0.01), greater decrease in heart rate (p < 0.01), and greater increase in vagal tone (p < 0.05). |
2006 | Jain [25] | 23 (crossover) | <37 weeks (1–7 days) | Slow massage of outer aspect of the leg | 2-min massage of the ipsilateral leg prior to heel stick (n = 13) and no massage prior to next heel stick 2–7 days later (10 infants had reverse order) | Neonatal Infant Pain Scale NIPS (primary outcome) Heart rate, respiratory rate, oxygen saturation | NIPS (p < 0.001) and heart rate (p = 0.03) were higher after a heel stick with no massage. |
2005 | Arora [31] | 69 (23 oil massage, 23 massage, 23 controls) VLBW infants | <37 weeks | Standardized technique for the study as described in article | 10 min 4 times a day | Weight gain at 28 days after enrolment (primary), length, head circumference triceps skin fold thickness, neurobehavior (NBAS), serum triglycerides. | No significant differences in any of the measured parameters. Trend for increased weight gain/day in massage group (p = 0.07). |
2005 | Sankaranara-yanan [28] | 112 (38 coconut oil, 37 mineral oil, 37 controls) | Mean 34.8 weeks (day 2 of life) | TKS | Four times a day for 31 days. | Weight gain velocity over the first 31 days of life (primary), length gain velocity, head growth, neuro-behavioral outcome, incidence of adverse events | Coconut oil massage group had a greater weight gain velocity compared to mineral oil (p < 0.05) and control groups (p < 0.05). Infants receiving coconut oil massage also showed a greater length gain velocity compared to controls (p < 0.05). No significant difference in other measures. |
2005 | Diego [30] | 48 (16 massage, 16 light pressure sham massage, 16 controls) | 22–37 weeks, mean ~30 (9–76 days, mean 29–34, no significant N difference between groups) | TKS | 15 min 3 times a day for 5 days | Weight gain, vagal activity (HRV), gastric motility (EGG), days to discharge, caloric intake | Massage group had greater weight gain (p < 0.01), increased vagal tone (p < 0.05) and increased gastric motility (p < 0.01) during and after treatment. Weight gain was significantly related to gastric motility (p < 0.01) and vagal tone (p < 0.01). No differences in other parameters. |
2005 | Lee [29] | 26 (13 massage, 13 controls) | < 36 weeks (second day after starting enteral feeds) | TKS | 15 min massage twice daily for 10 days | Weight, vagal tone, heart rate, oxygen saturation, and behavioral responses (behavioral states, motor activity, behavioral distress) | Massage group had significantly higher vagal tone after massage (p = 0.05) no change in controls. Massage group had higher scores for awake state (p = 0.000), fidgeting or crying (p = 0.04), and motor activity (p = 0.04) than controls. |
2005 | Solanki [27] | 120 (40 coconut oil, 40 safflower oil, 40 no oil) | Three groups: GA < 34 weeks, GA 34–37 weeks, GA > 37 weeks | Not specified | 5 mL of oil massaged for 10 min 4 times a day for 5 days | Serum triglycerides, serum fatty acid profile (linoleic, arachidonic, alpha linolenic acid, docosahexaenoic acids and saturated fats) | Serum triglyceride values were significantly higher after massage in all groups compared to baseline (coconut oil p < 0.001, safflower oil p < 0.001, controls p < 0.05). There was a significant rise in linoleic and arachidonic acid in the safflower oil group (p < 0.001) and saturated fats in coconut oil group (p < 0.001). |
2004 | Aly [32] | 30 (15 massage, 15 controls) | 28–35 weeks (< 2 weeks) | TKS | Daily massage until infant reached 1.8 kg of weight. | Serum type I collagen C-terminal propeptide (PICP) and urinary pyridinoline crosslinks of collagen (Pyd) | Serum PICP increased in massage group (p < 0.01) and decreased in control group (p < 0.01) compared to baseline, and this change differed significantly between massage group and controls (p = 0.0001). Urinary Pyd increased in both groups compared to baseline (p < 0.01 for both) but did not differ between the groups. |
2002 | Ferber [33] | 57 (21 massage by mother, 17 massage by professional, 19 controls) | 26–34 weeks, mean 31 weeks (mean 12–17 days) | TKS (modified) | 15 min massage 3 times a day for 10 days | Weight gain Calorie intake | Infants massaged by either their mother or professional gained more weight than controls (p = 0.03). No significant difference in caloric intake. |
1993 | Wheeden [34] | 30 (15 massage, 15 controls) All cocaine exposed infants | <37 weeks, mean 30 weeks (mean 16 days in controls, 20 days in massage group, NS) | TKS | 15 min massage 3 times a day for 10 days | Weight gain, calorie intake, stress behavior, behavior (NBAS) | Massage group had greater weight gain per day (p = 0.009) than controls. There was no difference in feed type or caloric intake. Massage group had fewer postnatal complications (p = 0.005) and stress behaviors (p = 0.05) and more mature motor behaviors at the end of the 10-day study period (p = 0.02) than controls. |
1993 | Scafidi [35] | 93 (50 massage, 43 controls) | 26–36 weeks, mean 30 weeks (mean 15 days) | TKS | 15 min massage 3 times a day for 10 days | Weight gain, calorie intake, stress behavior, behavior (NBAS) | Massage group had greater average daily weight gain (p < 0.01) than controls. Factors that predicted higher weight gain were history of obstetric complications, higher caloric intake and longer stay in intermediate nursery. |
© 2017 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Niemi, A.-K. Review of Randomized Controlled Trials of Massage in Preterm Infants. Children 2017, 4, 21. https://doi.org/10.3390/children4040021
Niemi A-K. Review of Randomized Controlled Trials of Massage in Preterm Infants. Children. 2017; 4(4):21. https://doi.org/10.3390/children4040021
Chicago/Turabian StyleNiemi, Anna-Kaisa. 2017. "Review of Randomized Controlled Trials of Massage in Preterm Infants" Children 4, no. 4: 21. https://doi.org/10.3390/children4040021